Abstract 11511: Metabolic Syndrome is an Independent Predictor of Cardiovascular Events in Patients With Atrial Fibrillation
OBJECTIVE: Metabolic syndrome (MetS) increased the risk of ischemic events. Increased risk to develop atrial fibrillation (AF) has been recognized in MetS. Studies on the prevalence of MetS in AF population are lacking. The impact of MetS on cardiovascular events incidence in AF patients under oral anticoagulants (OAT) has never been investigated.
Methods: We prospectively analyzed 810 consecutive AF patients under OAT. Metabolic syndrome was defined according to modified ATP-III criteria.
RESULTS: Patients were followed-up for a median time of 25.4 months (IQR: 15.1-46.2; 2033 patients/year). Mean age was 73.1 years and 55.3% were male. 25.4% patients were obese (BMI ≥30), and 58.6% met the criteria for MetS. At baseline patients with and without MetS were significantly different for BMI, waist circumference, CHA2 DS2-VASc score, HDL cholesterol, triglycerides, glycemia, hypertension, diabetes, heart failure, history of myocardial infarction. Use of ACE inhibitors/sartans, beta blockers, oral hypoglycemic agents, insulin and statins was significantly more frequent in patients with MetS. No differences were found in age, time in therapeutic range and history of stroke/TIA between the two groups. 89 patients (10.98%) experienced a primary outcome during follow-up: 31 AMI/Revascularization, 22 stroke/TIA and 36 cardiovascular deaths. Kaplan Meier curves (fig 1) showed that AF patients with MetS had more probability of experiencing MACEs (log-rank test: p=0.003); a sub-analysis demonstrated that NVAF patients with MetS had more AMI/Revascularization compared to those without (log-rank test: p=0.005). In a Cox proportional hard model age (≥75 years), history of stroke/TIA, history of myocardial infarction/cardiac revascularization and MetS independently predicted cardiovascular events.
CONCLUSION: In AF patients receiving OAT MetS is and independent predictor of cardiovascular events and, in particular, of AMI/Revascularization
- © 2013 by American Heart Association, Inc.